New diagnosis - have some questions

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jtrezzo

jtrezzo

Member Since 2015
Hello everyone, new here. I recently brought my boy, Cosmo, 8 years old, to the vet after he started urinating outside of the box, and also noticed that he was drinking more and naturally urinating more. It also seemed like he may be eating more. They did some lab tests and (after a $279 vet bill, which seems ridiculous) determined that he is diabetic. Now, try not to shun me, but I have been feeding him dry cat food (Nutro Max) which if I did the calculations correctly, contains 45% of calories from carbs, which from what I gather is BAD. What I have read says at least 50% protein, less than 35% fat, and less than 10% carbs should be in the diet, and really need to be fed wet canned food. I am first and foremost going to make the switch to a much better food ASAP (looking at Tiki & BFF, which I have to order online, and immediately going to at least get Royal Canin Ultra Light and whatever I can that meets the dietary criteria specified above at the store).

So, I am not wanting to start him on an insulin regimen until I can at least change the diet to the proper one, as I have read that it could even completely go into remission just based on dietary changes. I also read that if you change the diet, insulin doses would naturally need to change as well so I am thinking that is the first thing to do and judge it at a later time. The vet is wanting to charge what seems like hundreds more for "getting him set up on insulin" and the insulin itself, which at a librarian's salary who lives paycheck to paycheck, is simply not doable at the immediate time for me. I feel like I have been had by the vet and of course they are quick to put him on insulin to make a few hundred more off me.

What my questions come down to is this... Am I putting him in severe danger by not acting immediately? I have never noticed any SEVERE symptoms that make me believe it is life threatening. If I switch food and give it a couple weeks, is that acceptable?

Very confused and unsure at this point, so any help is greatly appreciated from people with experience!
 
Welcome! Can you share with us what Cosmo's blood sugar was at the vet when he was diagnosed? Nobody is going to shun you for feeding dry food, when you didn't know it wasn't good for a diabetic cat. I was feeding Shiloh Blue Buffalo when she was diagnosed, and tried to keep feeding it, as that was all she had eaten for years, and thought I would never get her off of it. But it was amazingly easy, and her levels show the effects. From my reading, there are really only two brands of dry food that meet the requirements. EVO Cat and Kitten, and Young Again Zero Carb. If you are going to switch food, and his blood sugar isn't outrageous, definitely try to do that before you introduce insulin. The change can make a huge difference in the blood sugar, and therefore in the need for insulin.

The most common syptoms are voracious eating, because his body can't process the food and he is essentially starving, excessive drinking, and the excessive peeing. However, long term uncontrolled diabetes can damage the internal organs. What insulin did the vet suggest?
 
Thanks for your reply. This is the thing about the vet....they seem totally unreliable. It is the first time I have taken him to this particular place. They sent the test to a lab, called me much later than they originally said, he said it was at 524, and then just said "Do you want to treat this? If so just bring him in, it will be a couple hundred to get him set up" or something along those lines. It really didn't sound like they cared, or didn't even offer any advice in the meantime about diet or anything of that sort. They also didn't suggest any type of insulin. I called and left a message for him the night prior and still have not heard back today. I don't know a great deal about blood sugar, but I am guessing it would be particularly high right after eating or shortly thereafter (especially the food I had been feeding him for years) and I am guessing that is exactly what the cat did as I basically woke up and had to put him in the carrier to take him to the vet. I am wondering if it is possible that the results could be exaggerated. I feel I need a second opinion at the very least.

As for the food, I bought a few different ones today, Blue Buffalo Wilderness, Wellness, Pure Balance low carb varieties, and the cats just went crazy for it with excitement and devoured it, so I have no problem switching at all. What would be considered "long-term"? I would like to at least try the new food for a couple weeks if it is not going to be any more harmful to him to wait.
 
A couple of weeks is not long term, but with a BG of 524, he might need to be on insulin soon. If you are going to change foods to a low carb, I would do it now. And wet is preferred, but if yours is absolutely a dry addict, the two brands I gave are about the only low carb options.

As far as their response, "do you want to treat this?" You would be so surprised at the amount of people that won't even bother with insulin or diet changes, but just get the diagnosis and be done with the pet. One of the things that we do a lot of here is home test. If you look at the link in my signature that says "Shiloh's SS" you will see the home testing that I do. It is an invaluable resource to know how your kitty is doing.
 
Hi Cosmo's mom and welcome to you both.

Did the vet check for ketones? You need to know if Cosmo is ketone prone because if he is then you need to start insulin therapy sharpish otherwise Cosmo would be at risk of developing diabetic ketoacidosis (DKA) - a potentially life-threatening complication of diabetes that is very expensive to treat. If you want to test at home you can get Ketodiastix test strips and check his urine for ketones.

I'm assuming you're in the States. I'd recommend you get hold of a glucometer and start learning to home test Cosmo's BG at home (we can teach you how - it's pretty straightforward). It will give you information on his blood glucose (BG) levels in real time, it will help you to monitor the effects of any diet changes and also help you keep him safe if he does require insulin (and at 524 that's a distinct possibililty). Home blood glucose tests can provide better data for dosing decisions as they will eliminate the problem of vet stress which can spike BG levels and present a false picture of Cosmo's blood sugar levels. Also, home testing will allow you to run glucose curves at home (series of tests to see how BG changes during a 12-hour period) and it will save you a lot of money since you won't need to pay a vet to do them. Rhonda has already introduced you to our spreadsheet tracking system. We can help you set one up for Cosmo.

WRT your feelings about the vet who diagnosed Cosmo, diabetes regulation is a marathon, not a sprint, and it really helps to have a good partnership with the treating vet. If you have no history with the diagnosing vet, it might not be a bad idea at all to shop around for a vet you'll feel comfortable with going forward.

Ideally you should look at cat-friendly insulins like Lantus, Levemir, Prozinc or PZI. Cats metabolize insulin quickly and the aforementioned insulins last longer and give better results than others like Vetsulin (which is more suited to canine diabetics).

Here's a link to the FAQ subforum index. It's a great place to get started with learning how to help your sugar kitty.

http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/
 
If you decide to find another vet for a second opinion or to switch take a look at my signature link Vet Interview Topics for some questions to ask.
 
Very helpful info! I am going to request a copy of the lab test results from the vet so that I can view them myself, as well as for purposes of shopping around. I am thinking home testing is certainly a good idea, and would give a more realistic picture. Cosmo is very skiddish and frightens easily so I would not be surprised if it was a big spike in the test done at the vet's office. Do you have any recommendations for a good starter setup for a meter and related supplies?
 
The Relion Confirm and Micro glucometers are popular with US members - available at Walmart (and IIRC, they're the same as the Arkray meters available from ADW). I think they only need a small blood sample, and the test strips are reasonably priced.
 
Vet's are a blessing but also a pain some times... If it makes you feel better, I spent $600 on Terry when her eye went wonky and they told my it was nothing to worry about. I switched vets a few months later mostly by chance and she immediately saw that Terry's lens had detatched/ruptured. $900 later and an eye less turns out diabetes was causing it the whole time. :S

ANYWAYS
From what I've read it seems that immidiate insulin treatment that becomes unnecessary due to remission is safer than trying out the diet first when they are so high...

That being said I am new so I don't know all that much
 
There is a cat food comparison chart on Dr. Lisa Pierson's website (just google that), which provides carbohydrate content of many available brands of cat food. In addition to home-testing blood glucose, I also measure how much water Bat-Bat drinks every 24 hours. (Had I continued doing that when she was in diabetic remission, I would have known a lot sooner that she was heading back toward full-blown diabetes by her increasing water consumption.) What breed is Cosmo, and what does he weigh?

Don't hesitate to change vets if this one doesn't feel like a good fit. And welcome to FDMB!
 
Thank you for all the helpful replies. The food switch seems to have been going well so far. I am feeding the Tiki Cat and BFF canned varieties, two 2.8oz cans per day to each cat, which seems on the low side of what is recommended. Cosmo has always had a ravenous appetite since I’ve had him, and constantly wants more. This was a bad combination with the high carb dry food and an unlimited supply of food. However he is overweight at 15 lbs and I do need to get his weight down so restricting calories should help with that. I have to restrain him from devouring his can of food and moving on to steal the other cat’s can, which she eats much more slowly. I supplement them with high protein treats (Blue Buffalo, though I have read they are pretty sketchy and might not continue with them).

I have noticed quite an increase in Cosmo’s activity (back to chasing around the other cat) and seems generally more active, with the new food. I am now looking to start home testing before I take him back to a (new) vet, mostly so I can go in there with some numbers. Reading some stories on here about getting a cat on insulin and then having the BG go TOO low and having complications from that seems more scary to me. If it turns out the numbers are still very high with the home test I will expedite my trip to the vet for insulin treatment.

For a home meter, I am looking at the Up & Up (sold at Target) as it seems to have a low cost per year for strips and good ratings. Anyone have experience with that model?
 
jtrezzo said:
For a home meter, I am looking at the Up & Up (sold at Target) as it seems to have a low cost per year for strips and good ratings. Anyone have experience with that model?
Click to expand...

I am fairly new to all this but I'm so grateful to my vet for suggesting that I learn to home test. The sooner you start doing it the better. I got an AlphaTrak because I didn't know any better but the cost of the strips is wrecking my budget. So I'm now in the process of looking at the most recent Consumer Reports information and will get back to you on what I find. The price of the test strips seems to be one of the most critical factors in choosing.

When I bumped into this website and found the spreadsheet so I could organize my BG information, my learning and care giving skills really took a leap forward. You probably already know about this but I wanted to mention how helpful I found it to be just in case. :)

I hope this is helpful to you.
 
I use the Up and Up (target is my go-to store) and the strips are low cost. The meter is very reliable, and requires a very tiny sample size. Its very simple to use. One caveat, Target is changing pharmacy providers to CVS so I'm worried that their pharmacy supplies might change too and this meter's strips won't be available. I haven't asked the pharmasist yet, so I dunno. Doesn't matter much to me since the meter was like $12, I'll just get a different one if it happens. Meijer carries the same meter/strips under their generic brand as well.

As far as insulin, lantus/levemir is about $100 for a pen to get started on it + syringes which aren't expensive. Starting insulin sooner is better, because the sooner you start the more likely the cat is to go into remission which saves a lot of money in the long run.
 
The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
I went to Target today and purchased the Up & Up meter and test strips. I did a test on myself first and got 111 mg/dl. I then moved on to Cosmo. I had to do several pricks (the lancets that came with it are too fine I think) and finally got a little blood, tried to put it on the test strip but it was not enough, so did one more prick closer to the edge of the ear and got a decent amount of blood finally, touched the strip to it again (this might be bad to do? should I have used a fresh strip?) and ended up with a reading of 257 mg/dl. From what I can understand that is certainly not good, but a far cry from the 524 mg/dl that the vet said it was from their blood test. The test was done about 5 hours after he ate his dinner. So the test was kind of shoddy, but I think an overall success for my first try in that I at least got something. I am going to wait until tomorrow to try for a cleaner test, maybe pick up some wider lancets too.
 
Great job with testing. The Up and Up meter does give results when there is not a full drop of blood in the strip sometimes instead of the error message it should give. These don't seem to be accurate for me if not a full drop - the little window on the strip should be all full with blood if possible. If you don't get a full drop on the strip and no result happens, use a new strip.

I personally like the fine lancets, but they take a little practice. I put a bright desklight behind the ear so I can see "through" the ear and see where I'm poking.
 
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